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Individual

CHELSEA LAJUAN WHITEHEAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
237 HALLBROOK DR, FORT WORTH, TX 76134-3931
(817) 806-6090
Mailing address
237 HALLBROOK DR, FORT WORTH, TX 76134-3931
(817) 806-6090

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
374U00000X
Home Health Aide
376K00000X
Nurse's Aide
Primary
385H00000X
Respite Care

Other

Enumeration date
05/20/2018
Last updated
05/20/2018
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